{"reporting_entity_name":"Healthfirst Insurance Company","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-06-24","version":"2.0.0","provider_references":[{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}},{"npi":[1000000000,1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003858390],"tin":{"type":"npi","value":"1003858390"}},{"npi":[1003858390,1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1023172921],"tin":{"type":"npi","value":"1023172921"}},{"npi":[1013057363,1023172921,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003923434],"tin":{"type":"npi","value":"1003923434"}},{"npi":[1003923434,1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033124961],"tin":{"type":"npi","value":"1033124961"}},{"npi":[1013057363,1033124961,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033186093],"tin":{"type":"npi","value":"1033186093"}},{"npi":[1013057363,1033186093,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013924372],"tin":{"type":"npi","value":"1013924372"}},{"npi":[1013057363,1013924372,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033107743],"tin":{"type":"npi","value":"1033107743"}},{"npi":[1013057363,1033107743,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013985399],"tin":{"type":"npi","value":"1013985399"}},{"npi":[1013057363,1013985399,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013389089],"tin":{"type":"npi","value":"1013389089"}},{"npi":[1013057363,1013389089,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043455199],"tin":{"type":"npi","value":"1043455199"}},{"npi":[1013057363,1043455199,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063426377],"tin":{"type":"npi","value":"1063426377"}},{"npi":[1013057363,1063426377,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013998426],"tin":{"type":"npi","value":"1013998426"}},{"npi":[1013057363,1013998426,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043224355],"tin":{"type":"npi","value":"1043224355"}},{"npi":[1013057363,1043224355,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043279565],"tin":{"type":"npi","value":"1043279565"}},{"npi":[1013057363,1043279565,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":16,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063657963],"tin":{"type":"npi","value":"1063657963"}},{"npi":[1013057363,1063657963,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":17,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043394745],"tin":{"type":"npi","value":"1043394745"}},{"npi":[1013057363,1043394745,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":18,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053354100],"tin":{"type":"npi","value":"1053354100"}},{"npi":[1013057363,1053354100,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":19,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073569331],"tin":{"type":"npi","value":"1073569331"}},{"npi":[1013057363,1073569331,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":20,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083605661],"tin":{"type":"npi","value":"1083605661"}},{"npi":[1013057363,1073585691,1083605661,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":21,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063853869],"tin":{"type":"npi","value":"1063853869"}},{"npi":[1013057363,1063853869,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":22,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063498889],"tin":{"type":"npi","value":"1063498889"}},{"npi":[1013057363,1063498889,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063525442],"tin":{"type":"npi","value":"1063525442"}},{"npi":[1013057363,1063525442,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083621130],"tin":{"type":"npi","value":"1083621130"}},{"npi":[1013057363,1073585691,1083621130,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043267727],"tin":{"type":"npi","value":"1043267727"}},{"npi":[1013057363,1043267727,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":26,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033270699],"tin":{"type":"npi","value":"1033270699"}},{"npi":[1013057363,1033270699,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":27,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053441907],"tin":{"type":"npi","value":"1053441907"}},{"npi":[1013057363,1053441907,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083633036],"tin":{"type":"npi","value":"1083633036"}},{"npi":[1013057363,1073585691,1083633036,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1093777492],"tin":{"type":"npi","value":"1093777492"}},{"npi":[1013057363,1073585691,1093777492,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":30,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073670519],"tin":{"type":"npi","value":"1073670519"}},{"npi":[1013057363,1073585691,1073670519,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":31,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104982917],"tin":{"type":"npi","value":"1104982917"}},{"npi":[1013057363,1073585691,1104982917,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":32,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073535027],"tin":{"type":"npi","value":"1073535027"}},{"npi":[1013057363,1073535027,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":33,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1093718728],"tin":{"type":"npi","value":"1093718728"}},{"npi":[1013057363,1073585691,1093718728,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":34,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104956358],"tin":{"type":"npi","value":"1104956358"}},{"npi":[1013057363,1073585691,1104956358,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":35,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1093712911],"tin":{"type":"npi","value":"1093712911"}},{"npi":[1013057363,1073585691,1093712911,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":36,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053721563],"tin":{"type":"npi","value":"1053721563"}},{"npi":[1013057363,1053721563,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":37,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1144287426],"tin":{"type":"npi","value":"1144287426"}},{"npi":[1013057363,1073585691,1144287426,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":38,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174620629],"tin":{"type":"npi","value":"1174620629"}},{"npi":[1013057363,1073585691,1174530349,1174620629,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":39,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1164481529],"tin":{"type":"npi","value":"1164481529"}},{"npi":[1013057363,1073585691,1164481529,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":40,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1134133622],"tin":{"type":"npi","value":"1134133622"}},{"npi":[1013057363,1073585691,1134133622,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":41,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174689665],"tin":{"type":"npi","value":"1174689665"}},{"npi":[1013057363,1073585691,1174530349,1174689665,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":42,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1114925567],"tin":{"type":"npi","value":"1114925567"}},{"npi":[1013057363,1073585691,1114925567,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":43,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194748368],"tin":{"type":"npi","value":"1194748368"}},{"npi":[1013057363,1073585691,1174530349,1194748368,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":44,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1154461622],"tin":{"type":"npi","value":"1154461622"}},{"npi":[1013057363,1073585691,1154461622,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":45,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1124032982],"tin":{"type":"npi","value":"1124032982"}},{"npi":[1013057363,1073585691,1124032982,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":46,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1164464921],"tin":{"type":"npi","value":"1164464921"}},{"npi":[1013057363,1073585691,1164464921,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":47,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104808062],"tin":{"type":"npi","value":"1104808062"}},{"npi":[1013057363,1073585691,1104808062,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":48,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1114959327],"tin":{"type":"npi","value":"1114959327"}},{"npi":[1013057363,1073585691,1114959327,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":49,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184873135],"tin":{"type":"npi","value":"1184873135"}},{"npi":[1013057363,1073585691,1174530349,1184873135,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":50,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215100458],"tin":{"type":"npi","value":"1215100458"}},{"npi":[1013057363,1073585691,1174530349,1215100458,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":51,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194776351],"tin":{"type":"npi","value":"1194776351"}},{"npi":[1013057363,1073585691,1174530349,1194776351,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":52,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194889097],"tin":{"type":"npi","value":"1194889097"}},{"npi":[1013057363,1073585691,1174530349,1194889097,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":53,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083796213],"tin":{"type":"npi","value":"1083796213"}},{"npi":[1013057363,1073585691,1083796213,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":54,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104847888],"tin":{"type":"npi","value":"1104847888"}},{"npi":[1013057363,1073585691,1104847888,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":55,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184974529],"tin":{"type":"npi","value":"1184974529"}},{"npi":[1013057363,1073585691,1174530349,1184974529,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":56,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083623144],"tin":{"type":"npi","value":"1083623144"}},{"npi":[1013057363,1073585691,1083623144,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":57,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174768071],"tin":{"type":"npi","value":"1174768071"}},{"npi":[1013057363,1073585691,1174530349,1174768071,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":58,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194832477],"tin":{"type":"npi","value":"1194832477"}},{"npi":[1013057363,1073585691,1174530349,1194832477,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":59,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194889360],"tin":{"type":"npi","value":"1194889360"}},{"npi":[1013057363,1073585691,1174530349,1194889360,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":60,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1124072715],"tin":{"type":"npi","value":"1124072715"}},{"npi":[1013057363,1073585691,1124072715,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":61,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1205877172],"tin":{"type":"npi","value":"1205877172"}},{"npi":[1013057363,1073585691,1174530349,1205877172,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":62,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215030697],"tin":{"type":"npi","value":"1215030697"}},{"npi":[1013057363,1073585691,1174530349,1215030697,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":63,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215911946],"tin":{"type":"npi","value":"1215911946"}},{"npi":[1013057363,1073585691,1174530349,1215911946,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":64,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194900654],"tin":{"type":"npi","value":"1194900654"}},{"npi":[1013057363,1073585691,1174530349,1194900654,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":65,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174530349],"tin":{"type":"npi","value":"1174530349"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":66,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225097652],"tin":{"type":"npi","value":"1225097652"}},{"npi":[1013057363,1073585691,1174530349,1225097652,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":67,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225441710],"tin":{"type":"npi","value":"1225441710"}},{"npi":[1013057363,1073585691,1174530349,1225441710,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":68,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215150230],"tin":{"type":"npi","value":"1215150230"}},{"npi":[1013057363,1073585691,1174530349,1215150230,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":69,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1164589602],"tin":{"type":"npi","value":"1164589602"}},{"npi":[1013057363,1073585691,1164589602,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":70,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194728691],"tin":{"type":"npi","value":"1194728691"}},{"npi":[1013057363,1073585691,1174530349,1194728691,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":71,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225295512],"tin":{"type":"npi","value":"1225295512"}},{"npi":[1013057363,1073585691,1174530349,1225295512,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":72,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245251222],"tin":{"type":"npi","value":"1245251222"}},{"npi":[1013057363,1073585691,1174530349,1245251222,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":73,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225357452],"tin":{"type":"npi","value":"1225357452"}},{"npi":[1013057363,1073585691,1174530349,1225357452,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":74,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184717837],"tin":{"type":"npi","value":"1184717837"}},{"npi":[1013057363,1073585691,1174530349,1184717837,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":75,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225083074],"tin":{"type":"npi","value":"1225083074"}},{"npi":[1013057363,1073585691,1174530349,1225083074,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":76,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1235184649],"tin":{"type":"npi","value":"1235184649"}},{"npi":[1013057363,1073585691,1174530349,1235184649,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":77,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1235142472],"tin":{"type":"npi","value":"1235142472"}},{"npi":[1013057363,1073585691,1174530349,1235142472,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":78,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255498796],"tin":{"type":"npi","value":"1255498796"}},{"npi":[1013057363,1073585691,1174530349,1255498796,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":79,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245365196],"tin":{"type":"npi","value":"1245365196"}},{"npi":[1013057363,1073585691,1174530349,1245365196,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":80,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275974974],"tin":{"type":"npi","value":"1275974974"}},{"npi":[1013057363,1073585691,1174530349,1275974974,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":81,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255360517],"tin":{"type":"npi","value":"1255360517"}},{"npi":[1013057363,1073585691,1174530349,1255360517,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":82,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285717298],"tin":{"type":"npi","value":"1285717298"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285717298,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":83,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245299726],"tin":{"type":"npi","value":"1245299726"}},{"npi":[1013057363,1073585691,1174530349,1245299726,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":84,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275697187],"tin":{"type":"npi","value":"1275697187"}},{"npi":[1013057363,1073585691,1174530349,1275697187,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":85,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245248939],"tin":{"type":"npi","value":"1245248939"}},{"npi":[1013057363,1073585691,1174530349,1245248939,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":86,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215917224],"tin":{"type":"npi","value":"1215917224"}},{"npi":[1013057363,1073585691,1174530349,1215917224,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":87,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275553521],"tin":{"type":"npi","value":"1275553521"}},{"npi":[1013057363,1073585691,1174530349,1275553521,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":88,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285641514],"tin":{"type":"npi","value":"1285641514"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":89,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245370717],"tin":{"type":"npi","value":"1245370717"}},{"npi":[1013057363,1073585691,1174530349,1245370717,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":90,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1336145168],"tin":{"type":"npi","value":"1336145168"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1336145168,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":91,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1306190558],"tin":{"type":"npi","value":"1306190558"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1306190558,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":92,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255639043],"tin":{"type":"npi","value":"1255639043"}},{"npi":[1013057363,1073585691,1174530349,1255639043,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":93,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275782039],"tin":{"type":"npi","value":"1275782039"}},{"npi":[1013057363,1073585691,1174530349,1275782039,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":94,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346285657],"tin":{"type":"npi","value":"1346285657"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346285657,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":95,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1295743060],"tin":{"type":"npi","value":"1295743060"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1295743060,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":96,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1295742468],"tin":{"type":"npi","value":"1295742468"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1295742468,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":97,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1306930318],"tin":{"type":"npi","value":"1306930318"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1306930318,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":98,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326046467],"tin":{"type":"npi","value":"1326046467"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1326046467,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":99,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1356307656],"tin":{"type":"npi","value":"1356307656"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1356307656,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":100,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1356333884],"tin":{"type":"npi","value":"1356333884"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1356333884,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":101,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346241973],"tin":{"type":"npi","value":"1346241973"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346241973,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":102,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376546440],"tin":{"type":"npi","value":"1376546440"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1376546440,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":103,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1366459570],"tin":{"type":"npi","value":"1366459570"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366459570,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":104,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346274537],"tin":{"type":"npi","value":"1346274537"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346274537,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":105,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1366473183],"tin":{"type":"npi","value":"1366473183"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366473183,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":106,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346603107],"tin":{"type":"npi","value":"1346603107"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":107,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1366505463],"tin":{"type":"npi","value":"1366505463"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1366505463,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":108,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376588947],"tin":{"type":"npi","value":"1376588947"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1376588947,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":109,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285799700],"tin":{"type":"npi","value":"1285799700"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285799700,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":110,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346380870],"tin":{"type":"npi","value":"1346380870"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346380870,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":111,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1417027558],"tin":{"type":"npi","value":"1417027558"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1417027558,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":112,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346213469],"tin":{"type":"npi","value":"1346213469"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346213469,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":113,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376577247],"tin":{"type":"npi","value":"1376577247"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1376577247,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":114,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1386640084],"tin":{"type":"npi","value":"1386640084"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386640084,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":115,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376629485],"tin":{"type":"npi","value":"1376629485"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1376629485,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":116,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1386649804],"tin":{"type":"npi","value":"1386649804"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386649804,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":117,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1396117362],"tin":{"type":"npi","value":"1396117362"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396117362,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":118,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1407815830],"tin":{"type":"npi","value":"1407815830"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1407815830,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":119,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1407989288],"tin":{"type":"npi","value":"1407989288"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1407989288,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":120,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1427017854],"tin":{"type":"npi","value":"1427017854"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427017854,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":121,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437216975],"tin":{"type":"npi","value":"1437216975"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1437216975,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":122,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1386708550],"tin":{"type":"npi","value":"1386708550"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1386708550,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":123,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1407877137],"tin":{"type":"npi","value":"1407877137"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1407877137,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":124,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1467469023],"tin":{"type":"npi","value":"1467469023"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1467469023,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":125,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1457369381],"tin":{"type":"npi","value":"1457369381"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1457369381,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":126,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1447663943],"tin":{"type":"npi","value":"1447663943"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1447663943,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":127,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477570315],"tin":{"type":"npi","value":"1477570315"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1477570315,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":128,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437230034],"tin":{"type":"npi","value":"1437230034"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1437230034,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":129,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437523537],"tin":{"type":"npi","value":"1437523537"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1437523537,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":130,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1447255153],"tin":{"type":"npi","value":"1447255153"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1447255153,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":131,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1427063270],"tin":{"type":"npi","value":"1427063270"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427063270,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":132,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1427616002],"tin":{"type":"npi","value":"1427616002"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1427616002,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":133,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437197985],"tin":{"type":"npi","value":"1437197985"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1437197985,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":134,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437575040],"tin":{"type":"npi","value":"1437575040"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1437575040,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":135,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1457395766],"tin":{"type":"npi","value":"1457395766"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1457395766,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":136,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1518061928],"tin":{"type":"npi","value":"1518061928"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1518061928,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":137,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508815333],"tin":{"type":"npi","value":"1508815333"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1508815333,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":138,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508001405],"tin":{"type":"npi","value":"1508001405"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1508001405,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":139,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477640258],"tin":{"type":"npi","value":"1477640258"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1477640258,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":140,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477617645],"tin":{"type":"npi","value":"1477617645"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1477617645,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":141,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1487644993],"tin":{"type":"npi","value":"1487644993"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1487644993,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":142,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477616571],"tin":{"type":"npi","value":"1477616571"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1477616571,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":143,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1538173372],"tin":{"type":"npi","value":"1538173372"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1538173372,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":144,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528292596],"tin":{"type":"npi","value":"1528292596"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1528292596,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":145,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528428521],"tin":{"type":"npi","value":"1528428521"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1528428521,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":146,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1497961205],"tin":{"type":"npi","value":"1497961205"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1497961205,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":147,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508845322],"tin":{"type":"npi","value":"1508845322"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1508845322,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":148,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548367873],"tin":{"type":"npi","value":"1548367873"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1548367873,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":149,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548597198],"tin":{"type":"npi","value":"1548597198"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1548597198,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":150,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477798189],"tin":{"type":"npi","value":"1477798189"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1477798189,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":151,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1518998699],"tin":{"type":"npi","value":"1518998699"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1518998699,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":152,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1497701106],"tin":{"type":"npi","value":"1497701106"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1497701106,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":153,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578529954],"tin":{"type":"npi","value":"1578529954"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1578529954,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":154,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528024718],"tin":{"type":"npi","value":"1528024718"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1528024718,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":155,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578554630],"tin":{"type":"npi","value":"1578554630"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1578554630,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":156,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528125069],"tin":{"type":"npi","value":"1528125069"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1528125069,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":157,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568459204],"tin":{"type":"npi","value":"1568459204"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1568459204,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":158,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598724924],"tin":{"type":"npi","value":"1598724924"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1598724924,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":159,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568526739],"tin":{"type":"npi","value":"1568526739"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1568526739,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":160,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548315401],"tin":{"type":"npi","value":"1548315401"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548315401,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":161,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568548782],"tin":{"type":"npi","value":"1568548782"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1568548782,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":162,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619034154],"tin":{"type":"npi","value":"1619034154"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619034154,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":163,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619032273],"tin":{"type":"npi","value":"1619032273"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619032273,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":164,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598713745],"tin":{"type":"npi","value":"1598713745"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1598713745,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":165,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528133147],"tin":{"type":"npi","value":"1528133147"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1528133147,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":166,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619597390],"tin":{"type":"npi","value":"1619597390"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619597390,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":167,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528161916],"tin":{"type":"npi","value":"1528161916"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1528161916,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":168,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1609875772],"tin":{"type":"npi","value":"1609875772"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1609875772,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":169,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578526695],"tin":{"type":"npi","value":"1578526695"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1578526695,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":170,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578664470],"tin":{"type":"npi","value":"1578664470"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1578664470,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":171,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598755324],"tin":{"type":"npi","value":"1598755324"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1598755324,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":172,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1629087580],"tin":{"type":"npi","value":"1629087580"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1629087580,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":173,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568601342],"tin":{"type":"npi","value":"1568601342"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1568601342,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":174,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598703019],"tin":{"type":"npi","value":"1598703019"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1598703019,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":175,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1639209596],"tin":{"type":"npi","value":"1639209596"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1639209596,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":176,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1639234156],"tin":{"type":"npi","value":"1639234156"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1639234156,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":177,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598181091],"tin":{"type":"npi","value":"1598181091"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1598181091,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":178,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1639179328],"tin":{"type":"npi","value":"1639179328"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1639179328,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":179,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659492106],"tin":{"type":"npi","value":"1659492106"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1659492106,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":180,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659307817],"tin":{"type":"npi","value":"1659307817"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1659307817,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":181,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1629148259],"tin":{"type":"npi","value":"1629148259"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1629148259,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":182,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669440327],"tin":{"type":"npi","value":"1669440327"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1669440327,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":183,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669578324],"tin":{"type":"npi","value":"1669578324"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1669578324,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":184,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1629135850],"tin":{"type":"npi","value":"1629135850"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1629135850,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":185,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619341716],"tin":{"type":"npi","value":"1619341716"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619341716,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":186,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659470276],"tin":{"type":"npi","value":"1659470276"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1659470276,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":187,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679573083],"tin":{"type":"npi","value":"1679573083"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1679573083,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":188,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1689015059],"tin":{"type":"npi","value":"1689015059"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1689015059,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":189,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659546125],"tin":{"type":"npi","value":"1659546125"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1659546125,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":190,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659385474],"tin":{"type":"npi","value":"1659385474"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1659385474,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":191,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1710977012],"tin":{"type":"npi","value":"1710977012"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1710977012,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":192,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659360709],"tin":{"type":"npi","value":"1659360709"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1659360709,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":193,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659330173],"tin":{"type":"npi","value":"1659330173"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1659330173,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":194,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679587679],"tin":{"type":"npi","value":"1679587679"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1679587679,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":195,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1689708109],"tin":{"type":"npi","value":"1689708109"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1689708109,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":196,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1700886322],"tin":{"type":"npi","value":"1700886322"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1700886322,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":197,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720414154],"tin":{"type":"npi","value":"1720414154"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1720414154,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":198,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1699709576],"tin":{"type":"npi","value":"1699709576"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699709576,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":199,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1700887411],"tin":{"type":"npi","value":"1700887411"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1700887411,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":200,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1689880494],"tin":{"type":"npi","value":"1689880494"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1689880494,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":201,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720066384],"tin":{"type":"npi","value":"1720066384"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1720066384,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":202,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740337971],"tin":{"type":"npi","value":"1740337971"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1740337971,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":203,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740287531],"tin":{"type":"npi","value":"1740287531"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1740287531,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":204,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720185267],"tin":{"type":"npi","value":"1720185267"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1720185267,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":205,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679883037],"tin":{"type":"npi","value":"1679883037"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1679883037,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":206,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770573222],"tin":{"type":"npi","value":"1770573222"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1770573222,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":207,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770593956],"tin":{"type":"npi","value":"1770593956"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1770593956,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":208,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740233899],"tin":{"type":"npi","value":"1740233899"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1740233899,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":209,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1750737565],"tin":{"type":"npi","value":"1750737565"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1750737565,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":210,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770598104],"tin":{"type":"npi","value":"1770598104"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1770598104,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":211,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720030703],"tin":{"type":"npi","value":"1720030703"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1720030703,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":212,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801804364],"tin":{"type":"npi","value":"1801804364"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1801804364,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":213,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770924474],"tin":{"type":"npi","value":"1770924474"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1770924474,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":214,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740344910],"tin":{"type":"npi","value":"1740344910"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1740344910,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":215,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801803903],"tin":{"type":"npi","value":"1801803903"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1801803903,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":216,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1730237603],"tin":{"type":"npi","value":"1730237603"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1730237603,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":217,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770502635],"tin":{"type":"npi","value":"1770502635"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1770502635,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":218,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811240039],"tin":{"type":"npi","value":"1811240039"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1811240039,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":219,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770671182],"tin":{"type":"npi","value":"1770671182"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1770671182,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":220,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740389154],"tin":{"type":"npi","value":"1740389154"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1740389154,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":221,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1780600577],"tin":{"type":"npi","value":"1780600577"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1780600577,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":222,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811977796],"tin":{"type":"npi","value":"1811977796"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1811977796,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":223,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1760421713],"tin":{"type":"npi","value":"1760421713"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1760421713,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":224,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1790727543],"tin":{"type":"npi","value":"1790727543"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1790727543,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":225,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811338288],"tin":{"type":"npi","value":"1811338288"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1811338288,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":226,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770890410],"tin":{"type":"npi","value":"1770890410"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1770890410,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":227,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801857172],"tin":{"type":"npi","value":"1801857172"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1801857172,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":228,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811054034],"tin":{"type":"npi","value":"1811054034"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1811054034,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":229,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1851430235],"tin":{"type":"npi","value":"1851430235"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1851430235,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":230,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831910355],"tin":{"type":"npi","value":"1831910355"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1831910355,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":231,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1871678458],"tin":{"type":"npi","value":"1871678458"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1871678458,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":232,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1841295219],"tin":{"type":"npi","value":"1841295219"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1841295219,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":233,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831253004],"tin":{"type":"npi","value":"1831253004"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1831253004,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":234,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1881659274],"tin":{"type":"npi","value":"1881659274"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1881659274,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":235,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1871606764],"tin":{"type":"npi","value":"1871606764"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1871606764,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":236,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831229780],"tin":{"type":"npi","value":"1831229780"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1831229780,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":237,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801992631],"tin":{"type":"npi","value":"1801992631"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1801992631,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":238,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1841650330],"tin":{"type":"npi","value":"1841650330"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1841650330,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":239,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1821394016],"tin":{"type":"npi","value":"1821394016"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1821394016,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":240,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1851732069],"tin":{"type":"npi","value":"1851732069"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1851732069,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":241,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1821163718],"tin":{"type":"npi","value":"1821163718"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1821163718,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":242,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831515154],"tin":{"type":"npi","value":"1831515154"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1831515154,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":243,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1891852331],"tin":{"type":"npi","value":"1891852331"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891852331,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":244,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1902865355],"tin":{"type":"npi","value":"1902865355"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1902865355,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":245,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1891134904],"tin":{"type":"npi","value":"1891134904"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891134904,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":246,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1912925199],"tin":{"type":"npi","value":"1912925199"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1912925199,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":247,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932103413],"tin":{"type":"npi","value":"1932103413"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932103413,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":248,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922405190],"tin":{"type":"npi","value":"1922405190"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1922405190,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":249,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922162197],"tin":{"type":"npi","value":"1922162197"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1922162197,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":250,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952476988],"tin":{"type":"npi","value":"1952476988"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1952476988,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":251,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932256161],"tin":{"type":"npi","value":"1932256161"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932256161,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":252,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952418352],"tin":{"type":"npi","value":"1952418352"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1952418352,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":253,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1891842308],"tin":{"type":"npi","value":"1891842308"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891842308,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":254,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1942236427],"tin":{"type":"npi","value":"1942236427"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1942236427,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":255,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962422733],"tin":{"type":"npi","value":"1962422733"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1962422733,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":256,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922020338],"tin":{"type":"npi","value":"1922020338"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1922020338,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":257,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1912992215],"tin":{"type":"npi","value":"1912992215"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1912992215,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":258,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962408203],"tin":{"type":"npi","value":"1962408203"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1962408203,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":259,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972548568],"tin":{"type":"npi","value":"1972548568"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1972548568,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":260,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952347205],"tin":{"type":"npi","value":"1952347205"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1952347205,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":261,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1902800352],"tin":{"type":"npi","value":"1902800352"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1902800352,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":262,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922079094],"tin":{"type":"npi","value":"1922079094"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1922079094,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":263,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932182599],"tin":{"type":"npi","value":"1932182599"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932182599,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":264,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932280666],"tin":{"type":"npi","value":"1932280666"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932280666,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":265,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982737136],"tin":{"type":"npi","value":"1982737136"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190,1982737136],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":266,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982761425],"tin":{"type":"npi","value":"1982761425"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190,1982761425],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":267,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992131320],"tin":{"type":"npi","value":"1992131320"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190,1992131320],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":268,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992713564],"tin":{"type":"npi","value":"1992713564"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190,1992713564],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":269,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982611190],"tin":{"type":"npi","value":"1982611190"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":270,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982663423],"tin":{"type":"npi","value":"1982663423"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190,1982663423],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":271,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952332801],"tin":{"type":"npi","value":"1952332801"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1952332801,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":272,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982625661],"tin":{"type":"npi","value":"1982625661"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190,1982625661],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":273,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972523348],"tin":{"type":"npi","value":"1972523348"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1972523348,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":274,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982600680],"tin":{"type":"npi","value":"1982600680"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982600680,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":275,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972557379],"tin":{"type":"npi","value":"1972557379"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1972557379,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":276,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982771325],"tin":{"type":"npi","value":"1982771325"}},{"npi":[1013057363,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190,1982771325],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":277,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013071281],"tin":{"type":"npi","value":"1013071281"}},{"npi":[1013057363,1013071281,1073585691,1174530349,1285641514,1285735506,1285738849,1285842062,1346603107,1366491128,1386655405,1396753224,1427135664,1548339765,1619945334,1699790238,1891861787,1932363660,1982611190],"tin":{"type":"ein","value":"112241326","business_name":"Long Island Jewish Forest Hills"}}]},{"provider_group_id":278,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":279,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003858390],"tin":{"type":"npi","value":"1003858390"}}]},{"provider_group_id":280,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013389089],"tin":{"type":"npi","value":"1013389089"}}]},{"provider_group_id":281,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013924372],"tin":{"type":"npi","value":"1013924372"}}]},{"provider_group_id":282,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003923434],"tin":{"type":"npi","value":"1003923434"}}]},{"provider_group_id":283,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033107743],"tin":{"type":"npi","value":"1033107743"}}]},{"provider_group_id":284,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013998426],"tin":{"type":"npi","value":"1013998426"}}]},{"provider_group_id":285,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1023172921],"tin":{"type":"npi","value":"1023172921"}}]},{"provider_group_id":286,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013985399],"tin":{"type":"npi","value":"1013985399"}}]},{"provider_group_id":287,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033124961],"tin":{"type":"npi","value":"1033124961"}}]},{"provider_group_id":288,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043224355],"tin":{"type":"npi","value":"1043224355"}}]},{"provider_group_id":289,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033270699],"tin":{"type":"npi","value":"1033270699"}}]},{"provider_group_id":290,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043394745],"tin":{"type":"npi","value":"1043394745"}}]},{"provider_group_id":291,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033186093],"tin":{"type":"npi","value":"1033186093"}}]},{"provider_group_id":292,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043267727],"tin":{"type":"npi","value":"1043267727"}}]},{"provider_group_id":293,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043279565],"tin":{"type":"npi","value":"1043279565"}}]},{"provider_group_id":294,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043455199],"tin":{"type":"npi","value":"1043455199"}}]},{"provider_group_id":295,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053354100],"tin":{"type":"npi","value":"1053354100"}}]},{"provider_group_id":296,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053721563],"tin":{"type":"npi","value":"1053721563"}}]},{"provider_group_id":297,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053441907],"tin":{"type":"npi","value":"1053441907"}}]},{"provider_group_id":298,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063426377],"tin":{"type":"npi","value":"1063426377"}}]},{"provider_group_id":299,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063853869],"tin":{"type":"npi","value":"1063853869"}}]},{"provider_group_id":300,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063498889],"tin":{"type":"npi","value":"1063498889"}}]},{"provider_group_id":301,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063525442],"tin":{"type":"npi","value":"1063525442"}}]},{"provider_group_id":302,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073535027],"tin":{"type":"npi","value":"1073535027"}}]},{"provider_group_id":303,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073569331],"tin":{"type":"npi","value":"1073569331"}}]},{"provider_group_id":304,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073670519],"tin":{"type":"npi","value":"1073670519"}}]},{"provider_group_id":305,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083605661],"tin":{"type":"npi","value":"1083605661"}}]},{"provider_group_id":306,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083621130],"tin":{"type":"npi","value":"1083621130"}}]},{"provider_group_id":307,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063657963],"tin":{"type":"npi","value":"1063657963"}}]},{"provider_group_id":308,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083633036],"tin":{"type":"npi","value":"1083633036"}}]},{"provider_group_id":309,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083796213],"tin":{"type":"npi","value":"1083796213"}}]},{"provider_group_id":310,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083623144],"tin":{"type":"npi","value":"1083623144"}}]},{"provider_group_id":311,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1093712911],"tin":{"type":"npi","value":"1093712911"}}]},{"provider_group_id":312,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1093777492],"tin":{"type":"npi","value":"1093777492"}}]},{"provider_group_id":313,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104847888],"tin":{"type":"npi","value":"1104847888"}}]},{"provider_group_id":314,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1093718728],"tin":{"type":"npi","value":"1093718728"}}]},{"provider_group_id":315,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104956358],"tin":{"type":"npi","value":"1104956358"}}]},{"provider_group_id":316,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104808062],"tin":{"type":"npi","value":"1104808062"}}]},{"provider_group_id":317,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1104982917],"tin":{"type":"npi","value":"1104982917"}}]},{"provider_group_id":318,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1114925567],"tin":{"type":"npi","value":"1114925567"}}]},{"provider_group_id":319,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1124032982],"tin":{"type":"npi","value":"1124032982"}}]},{"provider_group_id":320,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1134133622],"tin":{"type":"npi","value":"1134133622"}}]},{"provider_group_id":321,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1114959327],"tin":{"type":"npi","value":"1114959327"}}]},{"provider_group_id":322,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1124072715],"tin":{"type":"npi","value":"1124072715"}}]},{"provider_group_id":323,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1144287426],"tin":{"type":"npi","value":"1144287426"}}]},{"provider_group_id":324,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1154461622],"tin":{"type":"npi","value":"1154461622"}}]},{"provider_group_id":325,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1164464921],"tin":{"type":"npi","value":"1164464921"}}]},{"provider_group_id":326,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1164589602],"tin":{"type":"npi","value":"1164589602"}}]},{"provider_group_id":327,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1164481529],"tin":{"type":"npi","value":"1164481529"}}]},{"provider_group_id":328,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174530349],"tin":{"type":"npi","value":"1174530349"}}]},{"provider_group_id":329,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174620629],"tin":{"type":"npi","value":"1174620629"}}]},{"provider_group_id":330,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174768071],"tin":{"type":"npi","value":"1174768071"}}]},{"provider_group_id":331,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174689665],"tin":{"type":"npi","value":"1174689665"}}]},{"provider_group_id":332,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194776351],"tin":{"type":"npi","value":"1194776351"}}]},{"provider_group_id":333,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184717837],"tin":{"type":"npi","value":"1184717837"}}]},{"provider_group_id":334,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184974529],"tin":{"type":"npi","value":"1184974529"}}]},{"provider_group_id":335,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184873135],"tin":{"type":"npi","value":"1184873135"}}]},{"provider_group_id":336,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194748368],"tin":{"type":"npi","value":"1194748368"}}]},{"provider_group_id":337,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194728691],"tin":{"type":"npi","value":"1194728691"}}]},{"provider_group_id":338,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194832477],"tin":{"type":"npi","value":"1194832477"}}]},{"provider_group_id":339,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194889097],"tin":{"type":"npi","value":"1194889097"}}]},{"provider_group_id":340,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194900654],"tin":{"type":"npi","value":"1194900654"}}]},{"provider_group_id":341,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194889360],"tin":{"type":"npi","value":"1194889360"}}]},{"provider_group_id":342,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1205877172],"tin":{"type":"npi","value":"1205877172"}}]},{"provider_group_id":343,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215100458],"tin":{"type":"npi","value":"1215100458"}}]},{"provider_group_id":344,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215911946],"tin":{"type":"npi","value":"1215911946"}}]},{"provider_group_id":345,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215917224],"tin":{"type":"npi","value":"1215917224"}}]},{"provider_group_id":346,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225097652],"tin":{"type":"npi","value":"1225097652"}}]},{"provider_group_id":347,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215030697],"tin":{"type":"npi","value":"1215030697"}}]},{"provider_group_id":348,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225083074],"tin":{"type":"npi","value":"1225083074"}}]},{"provider_group_id":349,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225295512],"tin":{"type":"npi","value":"1225295512"}}]},{"provider_group_id":350,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215150230],"tin":{"type":"npi","value":"1215150230"}}]},{"provider_group_id":351,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225441710],"tin":{"type":"npi","value":"1225441710"}}]},{"provider_group_id":352,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225357452],"tin":{"type":"npi","value":"1225357452"}}]},{"provider_group_id":353,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1235142472],"tin":{"type":"npi","value":"1235142472"}}]},{"provider_group_id":354,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1235184649],"tin":{"type":"npi","value":"1235184649"}}]},{"provider_group_id":355,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245251222],"tin":{"type":"npi","value":"1245251222"}}]},{"provider_group_id":356,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245248939],"tin":{"type":"npi","value":"1245248939"}}]},{"provider_group_id":357,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245365196],"tin":{"type":"npi","value":"1245365196"}}]},{"provider_group_id":358,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245370717],"tin":{"type":"npi","value":"1245370717"}}]},{"provider_group_id":359,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245299726],"tin":{"type":"npi","value":"1245299726"}}]},{"provider_group_id":360,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255498796],"tin":{"type":"npi","value":"1255498796"}}]},{"provider_group_id":361,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255639043],"tin":{"type":"npi","value":"1255639043"}}]},{"provider_group_id":362,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255360517],"tin":{"type":"npi","value":"1255360517"}}]},{"provider_group_id":363,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275553521],"tin":{"type":"npi","value":"1275553521"}}]},{"provider_group_id":364,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275974974],"tin":{"type":"npi","value":"1275974974"}}]},{"provider_group_id":365,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285641514],"tin":{"type":"npi","value":"1285641514"}}]},{"provider_group_id":366,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275697187],"tin":{"type":"npi","value":"1275697187"}}]},{"provider_group_id":367,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285717298],"tin":{"type":"npi","value":"1285717298"}}]},{"provider_group_id":368,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275782039],"tin":{"type":"npi","value":"1275782039"}}]},{"provider_group_id":369,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1295743060],"tin":{"type":"npi","value":"1295743060"}}]},{"provider_group_id":370,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1295742468],"tin":{"type":"npi","value":"1295742468"}}]},{"provider_group_id":371,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285799700],"tin":{"type":"npi","value":"1285799700"}}]},{"provider_group_id":372,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1306930318],"tin":{"type":"npi","value":"1306930318"}}]},{"provider_group_id":373,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1306190558],"tin":{"type":"npi","value":"1306190558"}}]},{"provider_group_id":374,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346213469],"tin":{"type":"npi","value":"1346213469"}}]},{"provider_group_id":375,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346274537],"tin":{"type":"npi","value":"1346274537"}}]},{"provider_group_id":376,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1336145168],"tin":{"type":"npi","value":"1336145168"}}]},{"provider_group_id":377,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326046467],"tin":{"type":"npi","value":"1326046467"}}]},{"provider_group_id":378,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346380870],"tin":{"type":"npi","value":"1346380870"}}]},{"provider_group_id":379,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346241973],"tin":{"type":"npi","value":"1346241973"}}]},{"provider_group_id":380,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1356307656],"tin":{"type":"npi","value":"1356307656"}}]},{"provider_group_id":381,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346285657],"tin":{"type":"npi","value":"1346285657"}}]},{"provider_group_id":382,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1366459570],"tin":{"type":"npi","value":"1366459570"}}]},{"provider_group_id":383,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1356333884],"tin":{"type":"npi","value":"1356333884"}}]},{"provider_group_id":384,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346603107],"tin":{"type":"npi","value":"1346603107"}}]},{"provider_group_id":385,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1366473183],"tin":{"type":"npi","value":"1366473183"}}]},{"provider_group_id":386,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1366505463],"tin":{"type":"npi","value":"1366505463"}}]},{"provider_group_id":387,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376577247],"tin":{"type":"npi","value":"1376577247"}}]},{"provider_group_id":388,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376588947],"tin":{"type":"npi","value":"1376588947"}}]},{"provider_group_id":389,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376546440],"tin":{"type":"npi","value":"1376546440"}}]},{"provider_group_id":390,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1386640084],"tin":{"type":"npi","value":"1386640084"}}]},{"provider_group_id":391,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1376629485],"tin":{"type":"npi","value":"1376629485"}}]},{"provider_group_id":392,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1386708550],"tin":{"type":"npi","value":"1386708550"}}]},{"provider_group_id":393,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1407989288],"tin":{"type":"npi","value":"1407989288"}}]},{"provider_group_id":394,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1386649804],"tin":{"type":"npi","value":"1386649804"}}]},{"provider_group_id":395,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1396117362],"tin":{"type":"npi","value":"1396117362"}}]},{"provider_group_id":396,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1407877137],"tin":{"type":"npi","value":"1407877137"}}]},{"provider_group_id":397,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1417027558],"tin":{"type":"npi","value":"1417027558"}}]},{"provider_group_id":398,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1407815830],"tin":{"type":"npi","value":"1407815830"}}]},{"provider_group_id":399,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1427616002],"tin":{"type":"npi","value":"1427616002"}}]},{"provider_group_id":400,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1427063270],"tin":{"type":"npi","value":"1427063270"}}]},{"provider_group_id":401,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1447255153],"tin":{"type":"npi","value":"1447255153"}}]},{"provider_group_id":402,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437216975],"tin":{"type":"npi","value":"1437216975"}}]},{"provider_group_id":403,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437523537],"tin":{"type":"npi","value":"1437523537"}}]},{"provider_group_id":404,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437230034],"tin":{"type":"npi","value":"1437230034"}}]},{"provider_group_id":405,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437575040],"tin":{"type":"npi","value":"1437575040"}}]},{"provider_group_id":406,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1437197985],"tin":{"type":"npi","value":"1437197985"}}]},{"provider_group_id":407,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1457395766],"tin":{"type":"npi","value":"1457395766"}}]},{"provider_group_id":408,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1427017854],"tin":{"type":"npi","value":"1427017854"}}]},{"provider_group_id":409,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1447663943],"tin":{"type":"npi","value":"1447663943"}}]},{"provider_group_id":410,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1467469023],"tin":{"type":"npi","value":"1467469023"}}]},{"provider_group_id":411,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1457369381],"tin":{"type":"npi","value":"1457369381"}}]},{"provider_group_id":412,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477616571],"tin":{"type":"npi","value":"1477616571"}}]},{"provider_group_id":413,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477617645],"tin":{"type":"npi","value":"1477617645"}}]},{"provider_group_id":414,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477570315],"tin":{"type":"npi","value":"1477570315"}}]},{"provider_group_id":415,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477640258],"tin":{"type":"npi","value":"1477640258"}}]},{"provider_group_id":416,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1487644993],"tin":{"type":"npi","value":"1487644993"}}]},{"provider_group_id":417,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1497961205],"tin":{"type":"npi","value":"1497961205"}}]},{"provider_group_id":418,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477798189],"tin":{"type":"npi","value":"1477798189"}}]},{"provider_group_id":419,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1518998699],"tin":{"type":"npi","value":"1518998699"}}]},{"provider_group_id":420,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508815333],"tin":{"type":"npi","value":"1508815333"}}]},{"provider_group_id":421,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1518061928],"tin":{"type":"npi","value":"1518061928"}}]},{"provider_group_id":422,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1497701106],"tin":{"type":"npi","value":"1497701106"}}]},{"provider_group_id":423,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508845322],"tin":{"type":"npi","value":"1508845322"}}]},{"provider_group_id":424,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508001405],"tin":{"type":"npi","value":"1508001405"}}]},{"provider_group_id":425,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528133147],"tin":{"type":"npi","value":"1528133147"}}]},{"provider_group_id":426,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528024718],"tin":{"type":"npi","value":"1528024718"}}]},{"provider_group_id":427,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528292596],"tin":{"type":"npi","value":"1528292596"}}]},{"provider_group_id":428,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548315401],"tin":{"type":"npi","value":"1548315401"}}]},{"provider_group_id":429,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528125069],"tin":{"type":"npi","value":"1528125069"}}]},{"provider_group_id":430,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548367873],"tin":{"type":"npi","value":"1548367873"}}]},{"provider_group_id":431,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528161916],"tin":{"type":"npi","value":"1528161916"}}]},{"provider_group_id":432,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528428521],"tin":{"type":"npi","value":"1528428521"}}]},{"provider_group_id":433,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568459204],"tin":{"type":"npi","value":"1568459204"}}]},{"provider_group_id":434,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548597198],"tin":{"type":"npi","value":"1548597198"}}]},{"provider_group_id":435,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568526739],"tin":{"type":"npi","value":"1568526739"}}]},{"provider_group_id":436,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1538173372],"tin":{"type":"npi","value":"1538173372"}}]},{"provider_group_id":437,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568601342],"tin":{"type":"npi","value":"1568601342"}}]},{"provider_group_id":438,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568548782],"tin":{"type":"npi","value":"1568548782"}}]},{"provider_group_id":439,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578526695],"tin":{"type":"npi","value":"1578526695"}}]},{"provider_group_id":440,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578664470],"tin":{"type":"npi","value":"1578664470"}}]},{"provider_group_id":441,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578529954],"tin":{"type":"npi","value":"1578529954"}}]},{"provider_group_id":442,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578554630],"tin":{"type":"npi","value":"1578554630"}}]},{"provider_group_id":443,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598181091],"tin":{"type":"npi","value":"1598181091"}}]},{"provider_group_id":444,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598755324],"tin":{"type":"npi","value":"1598755324"}}]},{"provider_group_id":445,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598703019],"tin":{"type":"npi","value":"1598703019"}}]},{"provider_group_id":446,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1609875772],"tin":{"type":"npi","value":"1609875772"}}]},{"provider_group_id":447,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598713745],"tin":{"type":"npi","value":"1598713745"}}]},{"provider_group_id":448,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619597390],"tin":{"type":"npi","value":"1619597390"}}]},{"provider_group_id":449,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619034154],"tin":{"type":"npi","value":"1619034154"}}]},{"provider_group_id":450,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598724924],"tin":{"type":"npi","value":"1598724924"}}]},{"provider_group_id":451,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619341716],"tin":{"type":"npi","value":"1619341716"}}]},{"provider_group_id":452,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1629135850],"tin":{"type":"npi","value":"1629135850"}}]},{"provider_group_id":453,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1619032273],"tin":{"type":"npi","value":"1619032273"}}]},{"provider_group_id":454,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1639209596],"tin":{"type":"npi","value":"1639209596"}}]},{"provider_group_id":455,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1629087580],"tin":{"type":"npi","value":"1629087580"}}]},{"provider_group_id":456,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1639179328],"tin":{"type":"npi","value":"1639179328"}}]},{"provider_group_id":457,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1629148259],"tin":{"type":"npi","value":"1629148259"}}]},{"provider_group_id":458,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1639234156],"tin":{"type":"npi","value":"1639234156"}}]},{"provider_group_id":459,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659307817],"tin":{"type":"npi","value":"1659307817"}}]},{"provider_group_id":460,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659330173],"tin":{"type":"npi","value":"1659330173"}}]},{"provider_group_id":461,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659470276],"tin":{"type":"npi","value":"1659470276"}}]},{"provider_group_id":462,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659385474],"tin":{"type":"npi","value":"1659385474"}}]},{"provider_group_id":463,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659360709],"tin":{"type":"npi","value":"1659360709"}}]},{"provider_group_id":464,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659546125],"tin":{"type":"npi","value":"1659546125"}}]},{"provider_group_id":465,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669440327],"tin":{"type":"npi","value":"1669440327"}}]},{"provider_group_id":466,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659492106],"tin":{"type":"npi","value":"1659492106"}}]},{"provider_group_id":467,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669578324],"tin":{"type":"npi","value":"1669578324"}}]},{"provider_group_id":468,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679587679],"tin":{"type":"npi","value":"1679587679"}}]},{"provider_group_id":469,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679573083],"tin":{"type":"npi","value":"1679573083"}}]},{"provider_group_id":470,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679883037],"tin":{"type":"npi","value":"1679883037"}}]},{"provider_group_id":471,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1689708109],"tin":{"type":"npi","value":"1689708109"}}]},{"provider_group_id":472,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1700887411],"tin":{"type":"npi","value":"1700887411"}}]},{"provider_group_id":473,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1689015059],"tin":{"type":"npi","value":"1689015059"}}]},{"provider_group_id":474,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1700886322],"tin":{"type":"npi","value":"1700886322"}}]},{"provider_group_id":475,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1699709576],"tin":{"type":"npi","value":"1699709576"}}]},{"provider_group_id":476,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1689880494],"tin":{"type":"npi","value":"1689880494"}}]},{"provider_group_id":477,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1710977012],"tin":{"type":"npi","value":"1710977012"}}]},{"provider_group_id":478,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720030703],"tin":{"type":"npi","value":"1720030703"}}]},{"provider_group_id":479,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720066384],"tin":{"type":"npi","value":"1720066384"}}]},{"provider_group_id":480,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720185267],"tin":{"type":"npi","value":"1720185267"}}]},{"provider_group_id":481,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1720414154],"tin":{"type":"npi","value":"1720414154"}}]},{"provider_group_id":482,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740389154],"tin":{"type":"npi","value":"1740389154"}}]},{"provider_group_id":483,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740233899],"tin":{"type":"npi","value":"1740233899"}}]},{"provider_group_id":484,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1730237603],"tin":{"type":"npi","value":"1730237603"}}]},{"provider_group_id":485,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770593956],"tin":{"type":"npi","value":"1770593956"}}]},{"provider_group_id":486,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770502635],"tin":{"type":"npi","value":"1770502635"}}]},{"provider_group_id":487,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1760421713],"tin":{"type":"npi","value":"1760421713"}}]},{"provider_group_id":488,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740287531],"tin":{"type":"npi","value":"1740287531"}}]},{"provider_group_id":489,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770598104],"tin":{"type":"npi","value":"1770598104"}}]},{"provider_group_id":490,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740337971],"tin":{"type":"npi","value":"1740337971"}}]},{"provider_group_id":491,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740344910],"tin":{"type":"npi","value":"1740344910"}}]},{"provider_group_id":492,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1750737565],"tin":{"type":"npi","value":"1750737565"}}]},{"provider_group_id":493,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770924474],"tin":{"type":"npi","value":"1770924474"}}]},{"provider_group_id":494,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770573222],"tin":{"type":"npi","value":"1770573222"}}]},{"provider_group_id":495,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770890410],"tin":{"type":"npi","value":"1770890410"}}]},{"provider_group_id":496,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1780600577],"tin":{"type":"npi","value":"1780600577"}}]},{"provider_group_id":497,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801803903],"tin":{"type":"npi","value":"1801803903"}}]},{"provider_group_id":498,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770671182],"tin":{"type":"npi","value":"1770671182"}}]},{"provider_group_id":499,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1790727543],"tin":{"type":"npi","value":"1790727543"}}]},{"provider_group_id":500,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801804364],"tin":{"type":"npi","value":"1801804364"}}]},{"provider_group_id":501,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811240039],"tin":{"type":"npi","value":"1811240039"}}]},{"provider_group_id":502,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801857172],"tin":{"type":"npi","value":"1801857172"}}]},{"provider_group_id":503,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801992631],"tin":{"type":"npi","value":"1801992631"}}]},{"provider_group_id":504,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811054034],"tin":{"type":"npi","value":"1811054034"}}]},{"provider_group_id":505,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811338288],"tin":{"type":"npi","value":"1811338288"}}]},{"provider_group_id":506,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811977796],"tin":{"type":"npi","value":"1811977796"}}]},{"provider_group_id":507,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831229780],"tin":{"type":"npi","value":"1831229780"}}]},{"provider_group_id":508,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831253004],"tin":{"type":"npi","value":"1831253004"}}]},{"provider_group_id":509,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1821394016],"tin":{"type":"npi","value":"1821394016"}}]},{"provider_group_id":510,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831515154],"tin":{"type":"npi","value":"1831515154"}}]},{"provider_group_id":511,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1841295219],"tin":{"type":"npi","value":"1841295219"}}]},{"provider_group_id":512,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831910355],"tin":{"type":"npi","value":"1831910355"}}]},{"provider_group_id":513,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1841650330],"tin":{"type":"npi","value":"1841650330"}}]},{"provider_group_id":514,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1821163718],"tin":{"type":"npi","value":"1821163718"}}]},{"provider_group_id":515,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1871606764],"tin":{"type":"npi","value":"1871606764"}}]},{"provider_group_id":516,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1851732069],"tin":{"type":"npi","value":"1851732069"}}]},{"provider_group_id":517,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1891134904],"tin":{"type":"npi","value":"1891134904"}}]},{"provider_group_id":518,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1881659274],"tin":{"type":"npi","value":"1881659274"}}]},{"provider_group_id":519,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1851430235],"tin":{"type":"npi","value":"1851430235"}}]},{"provider_group_id":520,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1891852331],"tin":{"type":"npi","value":"1891852331"}}]},{"provider_group_id":521,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1902800352],"tin":{"type":"npi","value":"1902800352"}}]},{"provider_group_id":522,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1871678458],"tin":{"type":"npi","value":"1871678458"}}]},{"provider_group_id":523,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1912925199],"tin":{"type":"npi","value":"1912925199"}}]},{"provider_group_id":524,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1891842308],"tin":{"type":"npi","value":"1891842308"}}]},{"provider_group_id":525,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1902865355],"tin":{"type":"npi","value":"1902865355"}}]},{"provider_group_id":526,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1912992215],"tin":{"type":"npi","value":"1912992215"}}]},{"provider_group_id":527,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922020338],"tin":{"type":"npi","value":"1922020338"}}]},{"provider_group_id":528,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922079094],"tin":{"type":"npi","value":"1922079094"}}]},{"provider_group_id":529,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922162197],"tin":{"type":"npi","value":"1922162197"}}]},{"provider_group_id":530,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1922405190],"tin":{"type":"npi","value":"1922405190"}}]},{"provider_group_id":531,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932182599],"tin":{"type":"npi","value":"1932182599"}}]},{"provider_group_id":532,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932280666],"tin":{"type":"npi","value":"1932280666"}}]},{"provider_group_id":533,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932256161],"tin":{"type":"npi","value":"1932256161"}}]},{"provider_group_id":534,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1942236427],"tin":{"type":"npi","value":"1942236427"}}]},{"provider_group_id":535,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932103413],"tin":{"type":"npi","value":"1932103413"}}]},{"provider_group_id":536,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952332801],"tin":{"type":"npi","value":"1952332801"}}]},{"provider_group_id":537,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952347205],"tin":{"type":"npi","value":"1952347205"}}]},{"provider_group_id":538,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952476988],"tin":{"type":"npi","value":"1952476988"}}]},{"provider_group_id":539,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952418352],"tin":{"type":"npi","value":"1952418352"}}]},{"provider_group_id":540,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962408203],"tin":{"type":"npi","value":"1962408203"}}]},{"provider_group_id":541,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962422733],"tin":{"type":"npi","value":"1962422733"}}]},{"provider_group_id":542,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972548568],"tin":{"type":"npi","value":"1972548568"}}]},{"provider_group_id":543,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972523348],"tin":{"type":"npi","value":"1972523348"}}]},{"provider_group_id":544,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972557379],"tin":{"type":"npi","value":"1972557379"}}]},{"provider_group_id":545,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982600680],"tin":{"type":"npi","value":"1982600680"}}]},{"provider_group_id":546,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982611190],"tin":{"type":"npi","value":"1982611190"}}]},{"provider_group_id":547,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982663423],"tin":{"type":"npi","value":"1982663423"}}]},{"provider_group_id":548,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982625661],"tin":{"type":"npi","value":"1982625661"}}]},{"provider_group_id":549,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982771325],"tin":{"type":"npi","value":"1982771325"}}]},{"provider_group_id":550,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992131320],"tin":{"type":"npi","value":"1992131320"}}]},{"provider_group_id":551,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982761425],"tin":{"type":"npi","value":"1982761425"}}]},{"provider_group_id":552,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982737136],"tin":{"type":"npi","value":"1982737136"}}]},{"provider_group_id":553,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013071281],"tin":{"type":"npi","value":"1013071281"}}]},{"provider_group_id":554,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992713564],"tin":{"type":"npi","value":"1992713564"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11717","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[214]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[51]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10605","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11777","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[39]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[33]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[66]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[179]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14092","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[53]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[91]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[111]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[242]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[261]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11572","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[41]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[57]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10960","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[47]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[248]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[35]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11554","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12078","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[90]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13669","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[46]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12208","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11772","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11206","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[161]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[218]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[234]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[118]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[270]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13815","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10549","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[196]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14642","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[94]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14843","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10065","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[190]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[145]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[271]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[238]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[58]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[199]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[45]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[239]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[43]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[157]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[178]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[109]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[84]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13045","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[203]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14092","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[266]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[61]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[74]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[101]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[258]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[132]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12078","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[63]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[174]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[142]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[136]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[217]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11576","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10591","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[204]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10065","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[112]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[186]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[32]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[42]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[237]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[185]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[128]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[129]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[183]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[250]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11229","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11229","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[100]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[62]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10452","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10451","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[97]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[235]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11576","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14141","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[87]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[208]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[177]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[82]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[115]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11580","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[255]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11706","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[125]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14224","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[30]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10457","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10960","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[212]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10595","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[134]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[264]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[144]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[187]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[189]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14224","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14621","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[38]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[81]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[241]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11691","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[147]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[64]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14895","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[73]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[137]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[99]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[119]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[110]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[34]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[236]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[175]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[105]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[79]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14905","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14209","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[70]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14217","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12208","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[156]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[152]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[180]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[113]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14213","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[259]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13669","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[59]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11219","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[154]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10993","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10019","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[126]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[31]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[226]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[85]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[247]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[71]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[36]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[173]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[182]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[50]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[95]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[263]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[225]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[240]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[80]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[188]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[245]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[213]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[221]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[167]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[83]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11777","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14141","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[170]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[141]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[123]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[69]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[246]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10990","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[171]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[54]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[197]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[116]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14843","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[164]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[206]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12572","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[60]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14760","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[96]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[103]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10457","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[93]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[148]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[184]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[78]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10019","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14895","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[211]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12572","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11746","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[121]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[252]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[68]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13905","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[472]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[150]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[216]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[135]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[223]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[195]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[149]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[160]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12983","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[198]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[193]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[158]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[120]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14213","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[249]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[191]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11795","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[194]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[162]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[102]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13126","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[38]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10962","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13815","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[207]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14621","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14217","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[210]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10595","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11691","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[104]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[222]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11580","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[106]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13045","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[209]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[88]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[269]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[201]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[65]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11706","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13126","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[92]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[231]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[349]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[273]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10549","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[181]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[257]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10310","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[163]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13690","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11717","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[268]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[251]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[176]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[98]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14642","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11772","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[230]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[165]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14905","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11219","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[56]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[117]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10452","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[127]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10451","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[131]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12771","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11795","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[244]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10310","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[220]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[108]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[49]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[89]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[229]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[256]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[265]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[274]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11554","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[227]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[40]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[275]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11355","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[44]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[260]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[272]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[74]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[140]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[130]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11355","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[151]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11572","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[262]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[276]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[255]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[107]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10605","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[232]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11746","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[224]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13690","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[76]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14760","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[75]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14048","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[86]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14048","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[37]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[143]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[267]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10990","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[496]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[233]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[52]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[55]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[243]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[228]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[155]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12771","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[192]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[253]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"12983","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[48]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10591","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10962","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[122]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[202]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[159]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[219]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[169]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[139]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[205]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[168]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[72]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[322]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14209","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10993","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[77]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[254]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"12866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[114]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[235]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[215]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[146]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[200]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[133]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14626","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[308]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[357]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10960","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[316]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[530]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11542","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[369]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10940","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[446]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13905","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[172]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"10025","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"14611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[166]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13903","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[419]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11418","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[519]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[358]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[527]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[552]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[471]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[434]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[428]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","cbsa":"24020","date_of_service":"2026-05-10","locality":"1328299","zip":"12028","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14760","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[348]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11691","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[375]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[288]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"33","date_of_service":"2026-05-10","locality":"1328299","zip":"12010","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[506]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[277]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[285]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[445]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[344]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[421]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[486]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[308]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[412]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10016","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[404]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[451]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[403]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[461]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[318]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[503]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[467]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[302]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14810","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[372]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"13820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[153]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14620","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[413]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[443]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[483]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14220","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[325]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[510]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[309]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[397]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10962","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[392]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[490]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11795","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[525]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[550]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[436]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[323]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"13421","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[540]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"11901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[394]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10019","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[317]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[409]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11772","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[295]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[425]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[512]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13669","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[341]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11030","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[370]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[382]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13690","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[354]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"13413","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[350]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[487]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[484]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[407]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[418]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[420]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[352]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12866","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[390]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[303]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10003","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[307]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[355]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13326","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[364]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[517]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[473]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[493]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[505]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[299]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[496]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[516]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","cbsa":"27060","date_of_service":"2026-05-10","locality":"1328299","zip":"13053","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14437","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[548]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"14432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11580","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[384]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10567","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[518]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[524]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[463]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[494]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[300]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14611","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[448]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10037","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[287]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11570","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[450]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[460]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[408]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"45060","date_of_service":"2026-05-10","locality":"1328299","zip":"13020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"13902","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[321]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10310","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[335]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[388]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[482]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"10035","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[554]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[533]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[458]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"12550","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"11206","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[124]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"10580","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10032","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[435]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[401]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[360]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","cbsa":"13780","date_of_service":"2026-05-10","locality":"1328299","zip":"13732","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[553]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"12078","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[376]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12208","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[422]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[459]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[429]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[387]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"10993","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[301]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[353]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"14210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[357]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[454]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[385]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[507]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[297]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[315]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11572","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[528]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10025","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[424]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[351]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","zip":"13820","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[441]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"11501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[399]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[320]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[544]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14617","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[542]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","zip":"11201","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[377]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11576","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[293]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11229","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[347]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[383]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"12308","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[416]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[440]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"14092","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"11219","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[310]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[280]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[395]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[312]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14213","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[529]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-05-10","zip":"14217","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[489]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","cbsa":"21300","date_of_service":"2026-05-10","locality":"1328299","zip":"14814","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[305]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"13021","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[311]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10990","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[444]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13905","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[455]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[509]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[433]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[336]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","cbsa":"15380","date_of_service":"2026-05-10","locality":"1328299","zip":"14001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[290]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"10958","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[452]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","zip":"10701","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[415]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[470]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"14209","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[337]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","cbsa":"35614","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10467","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[538]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10451","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[400]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11717","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[491]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","zip":"13126","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[361]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[522]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"12901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[289]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"11787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[547]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[398]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"11427","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[339]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[508]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","cbsa":"48060","date_of_service":"2026-05-10","locality":"1328299","zip":"13601","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[447]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14456","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[539]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","name":"All coding types","description":"All codes possible","date_of_service":"2026-05-10","zip":"11803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL","HA","","U1"]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-05-10","zip":"13502","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[342]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[551]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"10605","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[511]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11714","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"10536","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[545]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"10595","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[532]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[469]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[405]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[464]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[427]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"11706","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[411]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14843","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[286]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","zip":"12180","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[292]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","zip":"10461","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[279]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[468]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[449]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"11206","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[410]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","zip":"11743","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[340]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[423]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"0932","name":"Medical Rehabilitation Day Program - Full Day","description":"Medical Rehabilitation Day Program - Full Day","date_of_service":"2026-05-10","zip":"10025","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[138]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[67]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11803","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[306]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[500]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[386]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","cbsa":"40380","date_of_service":"2026-05-10","locality":"1328299","zip":"13143","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"10452","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[414]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"13815","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[485]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","cbsa":"28880","date_of_service":"2026-05-10","locality":"1320203","zip":"10910","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[282]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11040","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[365]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[492]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[479]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[546]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[328]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","cbsa":"28740","date_of_service":"2026-05-10","locality":"1320203","zip":"12401","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[531]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11746","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[402]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","zip":"14424","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[332]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11432","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[497]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10528","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[453]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"12801","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[515]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","zip":"10591","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[480]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","zip":"11373","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[298]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","zip":"11554","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[502]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","zip":"11235","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[319]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14830","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[379]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11234","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[331]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[330]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"10457","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[430]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[368]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","zip":"12983","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[475]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"11203","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[371]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[456]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[288]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[366]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11777","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[346]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[314]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[327]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[466]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10305","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[326]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[523]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[396]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14513","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[498]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14895","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[478]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"12742","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[477]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"14787","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[534]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"11794","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[543]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","cbsa":"35004","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[278]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[284]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","zip":"14214","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[294]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[499]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-05-10","zip":"10901","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[374]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"13676","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[438]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[501]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"10065","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[462]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[338]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[513]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[472]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[536]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","zip":"14020","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[521]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14224","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[304]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"11212","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[378]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[393]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[380]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","zip":"14642","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[381]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","zip":"14141","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[363]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","zip":"10802","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[313]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[481]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","zip":"14850","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[549]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[541]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","zip":"13045","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[488]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","zip":"11355","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[537]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[324]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"10549","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[457]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[526]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","zip":"12534","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[426]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10029","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[535]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[296]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[437]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[291]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[465]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[343]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[281]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[495]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[349]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[356]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","zip":"13210","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[442]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[283]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[520]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[504]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[334]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"13440","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[389]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-05-10","zip":"12771","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[463]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[524]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"14215","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[406]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[417]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[476]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","zip":"10996","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[431]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-05-10","zip":"10924","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[359]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","zip":"14621","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[362]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[329]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[514]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","zip":"11237","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[474]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","zip":"14302","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[391]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[367]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-05-10","zip":"14048","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[345]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","cbsa":"46540","date_of_service":"2026-05-10","locality":"1328299","zip":"13054","other_properties":[{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["SL",""]}],"provider_references":[333]}]}]}
